title: Critical evaluation of justifications for the transfusion of red blood cells: the reality of a government emergency hospital.
abstract: BACKGROUND
  Blood products and derivatives are indispensable resources in medical therapies. However, it is important to note that the number of donations is far from ideal. Despite constant campaign efforts, a deficit of 1 million units is expected by 2030.
  
  
  OBJECTIVE
  To determine the adequacy of the indications for red blood cell transfusion in an emergency hospital in Alagoas.
  
  
  METHODS
  This was a cross-sectional observational study conducted at the Alagoas Blood Center. Of a total of 2936 red blood cell transfusion requests in 2009, 334 were randomized and compared with transfusion parameters described in the literature (primary variable). After analysis, the transfusion requests were categorized as adequate, inadequate or inconclusive. This last group included all red blood cell transfusion requests with insufficient clinical information, rendering their classification as adequate or inadequate impossible. The secondary variable involved the reasons for red blood cell transfusion. A 95% confidence interval was used in the statistical analysis.
  
  
  RESULTS
  Forty-seven (14.07%) requests were adequate and 30 (8.98%) were inadequate. Most of the requests were classified as inconclusive (76.94%). The main indications for transfusion were upper gastrointestinal bleeding (26.95%), anemia (46.71%), hypovolemia/hypovolemic shock (10.78%) and sepsis/septic shock (3.29%).
  
  
  CONCLUSIONS
  It was not possible to reach a conclusion on the adequacy of the indication for transfusion in most of the cases. Therefore, it is important to adopt a transfusion protocol, rigorously analyze blood bank requests, to provide awareness campaigns on the rational use of blood and to implement strategies to use blood products more effectively.
authors.affiliation: Universidade Estadual de Ciências da Saúde de Alagoas - UNCISAL, Maceió, AL, Brazil.
authors.forename: Diego Agra
authors.initials: DA
authors.lastname: de Souza
authors.forename: Felipe Gama E
authors.initials: FG
authors.lastname: Silva
authors.forename: Paulo José Medeiros de Souza
authors.initials: PJ
authors.lastname: Costa
keywords: Blood banks; Blood preservation; Emergency service, hospital; Erythrocyte transfusion; Hospitals, public